I have to do that many times. I stress to moms that breast is best, that baby is not growing as it needs to. I explain that success is to provide for the infant whatever she can produce. I always let them know, that regarding what kind of feeding method, an infant needs a mother (parents) that loves him and care care of him, this is not a failure on her part, baby needs her, and she can provide for all his needs. A mother wants to care for her child, supplementation get with formula is how she can help him grow. Them we discuss ways to supplement.
Sent from my iPad
> On Sep 18, 2015, at 1:55 AM, Carmela Baeza <[log in to unmask]> wrote:
>
> Hi all,
>
> I recently had a case like this one, baby came in refered from another LC
> with similar weight (un)gain numbers, -2 z score. He was struggling at the
> breast, with that marasmus look, just struggling out of weakness. One of
> those sights that breaks your heart. Mother was a 46 year old single parent
> by choice.
> We worked on position and latch, which needed a lot of work, and then I
> gently explained to the mother that her baby needed more intake. Her face
> just seemed to close off and she did not seem to understand. I went over
> baby´s weight loss numbers with her, gently explaining that he was getting
> the inmunological benefits of her milk, but that he needed more calories.
> And she asked How can I do that? I explained about frequent pumping etc and
> also about some formula supplementation until her supply had gone up. She
> then said could not do any of those things. She could not take time to pump
> because she was too tired and had no support, being alone at home, and she
> could not give him formula because she felt that would mean her failure as
> a mother.
> I tell you, I was scared. I could see her deep sadness (probably postpartum
> depression) and understood both her claims - but her baby was starving NOW.
> I admit I had a big struggle with myself. My first reaction was anger, I
> could not help but think This is not about you right now, it is about your
> baby, a baby that you chose to have!! I had to swallow this hard feeling
> and breathe deep. I knew this mom was suffering too. After much gentle
> talking she agreed to move into her parents´ house (called them from my
> office) and do power pumping for two days and then return to see me. She
> did not agree to supplement the baby with anything else. When she left I
> was extremely worried. I called her LC and we agreed she would call the mom
> and encourage her to supplement the baby.
>
> That evening I called the mother and... good news. She had been to the
> pediatrician after seeing me because she felt she needed to confirm what I
> had told her about the baby´s weight. The ped confirmed and convinced the
> mother to supplement the baby with formula, and to work on the power
> pumping as we had agreed.
>
> Baby came in two days later and had gained 250 gr. Mother was more relaxed,
> said she had not been herself on the first day she saw me. She is now
> working with a perinatal psiquiatrist.
>
> So my question is, how would you have spoken to this mother? Should I have
> been more forceful as (I suppose) the pediatrician was? I guess I was
> afraid to act on my inner feelings of anger and maybe that held me back.
> This was a hard one for me.
>
> Always learning...
>
> Kika
>
> --
> Dra. Carmela Baeza
> Médico de Familia
> Consultora Certificada en Lactancia Materna IBCLC
> www.centroraices.com
> http://www.facebook.com/Consulta.Lactancia.Raices
> <http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>
>
> Autora de "Amar con los Brazos Abiertos"
> http://www.amazon.es/Amar-con-los-brazos-abiertos/dp/8426904688/ref=sr_1_1?s=books&ie=UTF8&qid=1420813499&sr=1-1&keywords=amar+con+los+brazos+abiertos
> <http://www.ediciones-encuentro.es/libro/amar-con-los-brazos-abiertos.html>
>
> Comprometida con el Derecho a Vivir
> http://derechoavivir.org
>
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